The latest version of the Senate GOP’s bill to partially repeal and replace Obamacare was pronounced dead the evening of Monday, July 17, when Utah senator Mike Lee and Kansas senator Jerry Moran announced their opposition, bringing the number of “no” votes to at least four. Where do things go from here on health care? No one knows. Here are five possibilities:

2. “Repeal-and-delay.”
3. A small bill.
4. Bipartisan bailout.
5. Nothing.

Part of why Obamacare is so unpopular is that it is neglects the typical American.

Obamacare is bad for the typical—or median—American for a variety of reasons, including: its unprecedented individual mandate; its inept manner of dealing with preexisting conditions, which has sent premiums soaring (by 40% over the past two years); its roughly $2 trillion price-tag (over a decade); and its consolidation and centralization of power and money at the expense of Americans’ liberty and their wallets. Rather than offering overdue tax breaks to everyone who buys his or her own health insurance, Obamacare instead gives direct subsidies to insurance companies (falsely labeled as “tax credits”) on behalf of the select few.

As Republicans deliberate over an alternative to Obamacare, this provides a huge opening. A more consumer-friendly system will go a long way towards reducing costs for all and bringing down overall health care spending.

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Tom Price, President Trump’s choice for secretary of Health and Human Services (HHS), has the distinction of being a better fit for the department he’s been picked to lead than any other Trump cabinet nominee. But this hasn’t helped Price gain Senate confirmation.

Price, 62, is an orthopedic surgeon. He ran an orthopedic clinic for 20 years in Atlanta before returning to Emory University, where he had finished his residency, as an assistant professor of orthopedic surgery. He also ran a clinic at Grady Memorial, Atlanta’s largest public hospital.

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Even as the individual mandate is about to be killed off (Congress is poised to reduce its penalty to $0, thereby effectively repealing it), some center-right policy wonks and politicians are trying to give life to a new idea that might be even worse—”auto-enrollment.”

Here’s how it would work: If an American citizen were made eligible for a tax credit for health insurance, but chose not to use it, the government could then “auto-enroll” that citizen in a health insurance policy of the government’s choosing. It would use the “tax credit” to pay for it. This is a terrible idea on its face, but here are five specific reasons why it is so:

1. It is paternalistic.
2. It would be a free-for-all for cronyism.
3. It would be very expensive.
4. It would feature federal spending that’s masquerading as tax cuts.
5. It would raise premiums.

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It didn’t take long for Republican leadership in both houses of Congress to get over the shock of winning the election last month and start gaming out a repeal plan. The details remain under discussion, but House speaker Paul Ryan, Senate majority leader Mitch McConnell, and Vice President-elect Mike Pence (who is working closely with Ryan and McConnell on repeal) are already coalescing around a rough legislative framework. The plan might be summed up as: repeal, delay, replace. More precisely, Republicans plan to repeal most of the law, delay the implementation of most of that repeal for at least two years—and figure out what to replace it with in the interim.

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In 2008, the year that Barack Obama was elected as president, the combined annual profits of America’s ten largest health insurance companies were $8 billion. Under Obamacare, the ten largest health insurers’ annual profits have risen to $15 billion. This is another fine example of the natural alliance between Big Government and Big Business, which flourishes at the expense of Main Street Americans.

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President Obama and Hillary Clinton love to talk about the “20 million people” who’ve allegedly been added to the health insurance rolls under Obamacare. But in truth, a lower percentage of Americans have private health insurance now than in 2007, even though Obamacare is the law. This is according to the federal government’s own figures. According to the Centers for Disease Control and Prevention, 67% of those living in the United States had private health insurance in 2007. Now, as of 2015, only 66% have private health insurance.

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“If you like your doctor, you can keep your doctor” was President Barack Obama’s signature catchphrase he used to sell the Affordable Care Act to the American people. Now Obamacare’s flagship website, healthcare.gov, no longer even addresses the issue.

Ironically, the section in question was the first public (if indirect) admission by the Obama administration that the president’s promise was less than a “guarantee.” As THE WEEKLY STANDARD first reported in July 2013, the website told consumers that they “may be able to keep your current doctor,” in contrast to the president’s unequivocal statement: “Here is a guarantee that I’ve made. If you have insurance that you like, then you will be able to keep that insurance. If you’ve got a doctor that you like, you will be able to keep your doctor.”

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In a Health Affairs article, Loren Adler and Paul Ginsburg from the Center for Health Policy at the Brookings Institution make the claim that Obamacare has lowered health insurance premiums. Adler and Ginsburg claim that, in 2014, premiums for the second-lowest cost “silver” plan were “between 10 and 21% lower than average individual market premiums in 2013,” the year before Obamacare went into effect. Yet the Government Accountability Office has found that, in early 2013, the median plan in the median state for a healthy 30-year-old man had an annual premium of just $1,558. By comparison, according to the Kaiser Health Calculator, the nationwide average annual premium for the second-lowest cost “silver” plan for a 30-year-old man is now $3,186—more than twice as much.

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For six years, it has been abundantly clear that Americans want Obamacare to be repealed—but only if a well-conceived conservative alternative is positioned to take its place. That’s why the recent release of the House GOP health care plan is a big deal. The new plan would of course repeal Obamacare. But it would also fix what the federal government had already broken even before the law was passed and made things so much worse.

The proposal pairs an Obamacare alternative with Medicaid reforms and the crucial Medicare reforms (amounting to a kind of “Medicare Advantage Plus”) that Speaker Paul Ryan and House Republicans have long championed. As Ryan put it after the proposal’s release, “The way I see it, if we don’t like the direction the country is going in—and we do not—then we have an obligation to offer an alternative….And that’s what this is.” He called the plan not merely “a difference is policy” but “a difference in philosophy.”

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